Healthcare Provider Details

I. General information

NPI: 1801356449
Provider Name (Legal Business Name): MEIYI SHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 READE PL STE 2200
POUGHKEEPSIE NY
12601-3970
US

IV. Provider business mailing address

21 READE PL STE 2200
POUGHKEEPSIE NY
12601-3970
US

V. Phone/Fax

Practice location:
  • Phone: 845-483-0698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number343057
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number343057
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: